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Anal fistula is common among those who have had an anal abscess. It develops between the skin and the muscular opening, anus, at the end of the digestive tract. Most of the fistula occurs as a result of the infection that starts in the anal gland which further causes an abscess. An anal fistula usually needs surgery for its treatment.

Anal Fistula

These are types of fistula depending on their location that include:

  • Inter-sphincteric fistula: It is the most common type of anal fistula which is an abnormal tract found near the anus or rectum. It is found between the internal and external sphincter muscles and ends close to the anus.
  • Trans-sphincteric fistula: The tract begins in the space between the internal and external sphincter muscles or in the space behind the anus and opens slightly outside the anal opening. It is also known as horseshoe fistula.
  • Supra-sphincteric fistula: It turns upwards to a point above the puborectal muscle and opens outside the anus.
  • Extra-sphincteric fistula: This happens by either Crohn’s disease or abscess. It begins at the rectum and extends downwards opening around the anus.
Types of Fistula

Causes of anal fistula

There are various glands that produce fluids which sometimes result in clogging. This builds up a lump of infectious tissues and the fluid which is known as an abscess. Other causes of anal fistula include:

  • Crohn’s disease which is an inflammatory disease of the intestine
  • Trauma
  • Sexually transmitted diseases
  • Tuberculosis
  • A condition called diverticulitis in which small pouches form in the large intestine and has inflammation
  • Cancer
  • Some ongoing problem that affects bowel

Symptoms of anal fistula

The symptoms of the anal fistula include:

  • Frequent anal abscess
  • Pain and swelling around the anus
  • Foul smelly discharge from an opening around the anus. As the fistula drains, the pain may reduce
  • Irritation on the skin around the anus from drainage
  • Pain with bowel movements
  • Pain while sitting
  • Bleeding
  • Fever and chills and feeling of fatigue

How to diagnose anal fistula?

Some fistula is easy to spot and some heal on their own. In the first place, the doctor usually diagnoses anal fistula by examining the area around the anus. Also, the doctor looks for the opening on the skin and oozing fluid. The doctor may put the finger into the anus during diagnosis. He may ask you to get imaging tests such as X-rays or CT scan or even colonoscopy. In addition, colonoscopy is the process where the doctor puts the camera into the colon through the anus to look inside the bowel. The surgeon performs it under anesthesia.

Colonoscopy - diagnosis of fistula

What are the treatment options for anal fistula?

Anal fistula is most of the time treatable but only with surgery. The surgery is to treat fistula along with protecting sphincter muscles which may cause incontinence if there is any damage. The doctor performs surgery for anal fistula under general anesthesia. Laser surgery is the latest treatment. In this treatment, the laser energy user probe gets inside the fistula canal destroying the fistula epithelium and also removing the tract. There are reasons to prefer laser over other traditional methods:

  • Minimally invasive procedure
  • Quick recovery
  • Resume normal activities within two days
  • Short hospital stay
  • No restrictions post-surgery

The traditional procedures include:

  • Fistulotomy where there is no or little sphincter muscle. In this, the skin over the tunnel is cut to convert it into the open groove. This heals the fistula from bottom up.
  • Lift procedure where the skin on the fistula opens, the sphincter muscles are spread and surgeons tie them.

Recovery after the surgery

Together with this after the surgery, the surgeon may ask you to take sitz bath which is a warm water bath to soak in the affected area. The doctor may recommend stool softeners or laxatives along with pain killers after the surgery. What you have to do is follow the instructions of the doctor for faster recovery. Therefore, if you do this, fistula will probably not come back. Above all, if you are willing to know more about the problem and laser surgery for anal fistula, consult a specialist at Pristyn Care.

Also Read in Hindi: भगन्दर क्या है, कारण, लक्षण, प्रकार और घरेलू उपाय

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